Roy Porter died earlier this month, at the age of
only 55.His death was a great loss for
those who study the history of medicine and especially the history of mental illness,
but he also had a broad range of interests.He wrote and edited books on the social history of London, the
Enlightenment, sexology, gout, and science, among many other subjects.He sparked the interest of other academics
on the topics he wrote on, and he was also that rare thing, a public
intellectual, with a wonderful ability to communicate ideas to a wide
audience.In Britain, he often appeared
on television and radio.

Porters latest book, Madness: A Brief History,
is a good example of his skills of setting out two thousand years of complex
history in a short space.The book is
arranged more by the themes that dominated the understanding and treatment of
madness over the ages, starting with Gods and demons, moving through the
growing medical and psychological approaches, the rise of asylums, then the
emptying of mental hospitals, the ascent of Freud and psychotherapy, and new
biological treatments such as electroshock treatment and medication.The book ends with a quick survey of the
current state of psychiatry, with particular mention of the proliferation of
diagnostic categories in DSM-IV-TR.

Madness is not a scholarly book,
and it rushes on from decade to decade often in moving from one sentence to
another.It focuses on Europe, with
occasional references to the United States, but with no discussion of
non-Western cultures.It is packed full
of information, although it may be an frustrating text to refer to if one were
attempting to use it for a systematic discussion of particular aspects of
madness; there are no footnotes.Fortunately Porter provides a large and helpful section in which he
recommends further reading.

While the book does not set
out to defend any particular thesis or theoretical orientation, Porters
fundamental orientation is liberal and humanistic; he is suspicious of the way
the rise in psychiatric authority can make society less tolerant of difference.But he also believes in getting facts right,
and he argues that there is little evidence to support Michel Foucaults claim
that there was a great confinement of the mad and poor starting in the
seventeenth century France.Porter has
an eye for interesting details that make the book especially enjoyable to read,
and the flow of ideas gives one a sense of his creative intelligence at work.

This is a very different
sort of history from Edward Shorters A History of
Psychiatry.Shorters book is
far longer and more detailed, focusing mostly on the nineteenth and twentieth
centuries, and has more of an axe to grind.Porters Madness, although a slighter work, is also more rounded
and gives the reader a stronger sense of how the understanding of madness fits
in other trends in the growth of Western culture.It would be a great starting place for anyone interested in
understanding the history behind our current approaches to mental illness.

Christian
Perring, Ph.D., is Chair of the Philosophy Department at Dowling College,
Long Island. He is editor of Metapsychology Online Review. His main
research is on philosophical issues in psychiatry. He is especially interested
in exploring how philosophers can play a greater role in public life, and he is
keen to help foster communication between philosophers, mental health
professionals, and the general public.

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